OBJECTIVE
To form the markers of early vascular aging (EVA) based on parameter of arterial stiffness (CAVI, cardio-ankle vascular index) and to study their prognostic significance for cardiovascular events in adult population of Tomsk (ESSE-RF epidemiological study).
MATERIAL AND METHODS
There were 342 people (543 men and 799 women) aged 25—64 (47.3±11.6) years. All ones underwent volumetric sphygmography for analysis of arterial stiffness (CAVI). Cardiovascular events were registered in prospective follow-up (mean 4.7 years). We analyzed several EVA markers regarding primary combined (mortality from cardiovascular diseases, non-fatal myocardial infarction or stroke) and secondary combined endpoints (all cardiovascular events).
RESULTS
We assessed the markers EVA-56, EVA-65, EVA-84 and EVA-97.5 formed as excess of the 56th, 65th, 84th and 97.5th percentiles of CAVI distribution in different age ranges. Moreover, we analyzed EVA-VS as excess of «vascular age» (VaSera-1500) over chronological age. Multivariate Cox model involving gender, age, obesity, smoking, arterial hypertension, diabetes mellitus and dyslipidemia confirmed prognostic value of EVA-65 (RR 3.38 95% CI 1.16—9.79, p=0.025), EVA-97.5 (RR 4.87, 95% CI 1.07—22.14, p=0.041) and EVA-VS (RR 5.16, 95% CI 1.4—19.03, p=0.014) for primary combined endpoint and EVA-97.5 (RR 3.59, 95% CI 1.1—11.69, p=0.034) for secondary combined endpoint.
CONCLUSION
EVA may be recommended in population studies to identify high-risk people among patients over 55 years old without previous myocardial infarction or stroke. The same is true for construction of new multivariate prognostic models. EVA is formed according to volumetric sphygmography data as excess of the 97.5th percentile of age-adjusted CAVI. EVA as excess of the 65th percentile of CAVI or excess of «vascular age» over chronological age is more promising for assessing individual prognosis of cardiovascular events in clinical practice and identifying high-risk persons.